INDIVIDUAL ACCOUNT OPENING FORM

Personal Information

Full Name

Date of Birth

Maiden Name

Nationality

Residential Address

Contact Number(s)

Email Address

Occupation

Employer's Name and Address (if applicable)

NIN NUMBER

Are you a politically exposed person (PEP) or closely associated with one?

Yes
No

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Next of Kin Details

Name

Relationship

Address

Phone Number

Email Address

Bank Details

Bank Account Name

Bank Name

Bank Account Number

BVN Number

Source of Income

Business
Employment
Others

Attached Documents

Valid Means of ID Card

Utility Bill

Declaration

I hereby declare that the information provided above is true and accurate to the best of my knowledge. I understand that the stockbroking firm will rely on this information to open my account and execute transactions on my behalf.

IMPORTANT INFORMATION

The stock market provides avenue for existing and potential investors to buy and sell shares of listed companies on the bourse of the Nigerian Exchange Ltd. Investment decisions leading to buy and sell of shares may result to a loss or gain. In no event shall Valmon Securities Ltd be liable to any investors (existing or potential) or third parties for investment losses, lost gains or lost opportunity.

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Date